Document
COVID-19 Patient Impact Module Form - State and Local Health Departments
ICR 202005-0920-014 · OMB 0920-1290 · Object 101552601.
This document may belong to an older filing. More recent activity for OMB 0920-1290:
Document Viewer [docx]
Document Metadata
| File Type | application/octet-stream |
|---|---|
| File Title | COVID-19 Patient Impact Module Form - State and Local Health Departments |
| Author | Wattenmaker, Lauren (CDC/DDID/NCEZID/DHQP) |
| Last Modified By | Writer |
| File Modified | 2020-05-29 |
| File Created | 2026-05-06 |
| Conversion State | complete |